Hospital brass declined interviews Tuesday, but LHSC published a statement on its website from outgoing chief executive Murray Glendining that lays out the case for closing the institute, which opened its doors in 1981.

“Patient referrals to the Cardiac Fitness Institute (CFI) will end March 2018,” Glendining wrote. “These services do not fall under the mandate of acute care hospitals and LHSC receives no funding to support similar services and can no longer subsidize the costs of the CFI program.”

Hospital officials said they haven’t decided how to use the space. “There has been no final decision made about the use of physical space at this time,” officials wrote.

After March, patients who survive heart attacks, have heart disease or who are recovering from valve or bypass surgery will be referred to a rehabilitation program operated by St. Joseph’s Health Care London.

Patrick said the cardiac rehabilitation and secondary prevention program at St. Joe’s has had wait times as long as five months.

There are key differences between the fitness institute and the rehab program:

St. Joe’s rehab program provides exercise and diet guidance for six months, while the fitness institute does so indefinitely, with patients allowed to use exercise equipment in the clinic.

Staff at the rehab program offer stress tests for patients under its care, but after six months those tests can be ordered only by doctors independent of the program. The fitness institute offers annual stress tests, which brings in between $90,000 and $110,000 from Ontario’s Health Ministry.

St. Joe’s rehab program is funded by the Health Ministry but LHSC’s fitness institute is not and the hospital says it subsidizes about half of the $300,000 annual cost, with donations covering the balance.

“The (fitness institute) program has been under increased scrutiny for the past several years as the funding environment has become increasingly challenging for LHSC, leading to the decision to wind it down,” hospital officials wrote on a web page that explains its rationale in a series of questions and answers.

As to whether patients will fare worse, as well as or better at St. Joe’s, officials at LHSC wrote that question is best raised with the Health Ministry and an agency that provides advice on cardiac and stroke care, the recently formed Corhealth Ontario.

“We can only hope that those patients continue to have access (to the programs they need,” said Alexandra Maheux, a spokesperson for the London office of the Heart and Stroke Foundation.

Patrick said he learned in mid-December the plug would be pulled when he happened upon a meeting at which the institute’s staff were told the bad news.

Hospital administrators have tried to close the institute five or six times over the decades, most recently in 2010, he said.

But this time, Patrick won’t be around long to fight the plans — he’s approaching age 70 and plans to retire in May because he’s fed up with what he says has been chronic underfunding of health needs in Ontario.

“I like practising medicine, but I can’t stand what’s happening . . . I can’t do this anymore,” he said.

If this seems personal to Patrick, it is — he had bypass surgery in 2014. “Damn right, I have a vested interest,” he said

Though it’s true the province has failed to fund chronic care for cardiac patients, hospitals in Toronto, Ottawa and Windsor all fund programs on their own, Patrick said.

The institute was given a reprieve when Bonnie Adamson served as chief executive, but since she left, hospital brass have undermined the services it offers, eliminating its single nurse, reducing staff and getting rid of all but five parking spaces reserved for those with handicaps, Patrick said.

“In the last four or five years they have been slowly strangling us,” he said.

That’s left only about 10 new patients a month referred to the institute, he said.

LHSC says fewer than 10 patients a month are referred to the institute, with about 100 who have continued to use its exercise facilities on an ongoing basis.

But Patrick maintains the closing would leave in limbo the 1,400 or so patients who still use the institute for ongoing help.

“Who’s going to look after them?” he asked.

Hospital officials insist patients won’t be hurt, writing, “There is excellent collaboration between the LHSC and St. Joseph’s teams to ensure seamless transitions for these patients . . . Patients who have previously concluded their six-month cardiac rehab program are encouraged to continue their exercise program within the community and (the institute’s) leadership will work with the patient advisory council to determine what support can be provided for these transitions.”

Asked if his patients fare better than those who go to the six-month program at St. Joe’s, Patrick said he’s confident that was the case, but that he has never been given funding to do research that would show that.

Research elsewhere suggests that half of patients stop making needed changes after they complete a short-term program, while he estimates the compliance rate among his patients is closer to 75 to 80 per cent.